India

摘要： Breast cancer is the commonest malignancy among women globally.From being fourth in the list of most common cancers in India during the 1990s,it has now become the first.In this review,we examine the available literature to understand the factors that contributed to the high burden of breast cancer in the country.We also provide the landscape of changes in the field of early diagnosis and the treatment modalities as well as the limitations of the Indian healthcare delivery systems(e.g.,delayed diagnosis,human resources and funding for treatment).This review also sheds light on the newer interventions and the future of breast cancer management keeping in mind the coronavirus disease 2019 imposed limitations.

摘要： BACKGROUND Burden due to intellectual disability(ID) is only third to the depressive disorders and anxiety disorders in India. This national burden significantly contributes to the global burden of ID and hence one has to think globally and act locally to reduce this burden. At its best the collective prevalence of ID is in the form of narrative reviews. There is an urgent need to document the summary prevalence of ID to enhance further policymaking, national programs and resource allocation.AIM To establish the summary prevalence of ID during the past 60 years in India.METHODS Two researchers independently and electronically searched Pub Med, Scopus, and the Cochrane library from January 1961 to December 2020 using appropriate search terms. Two other investigators extracted the study design, setting, participant characteristics, and measures used to identify ID. Two other researchers appraised the quality of the studies using the Joanna Briggs Institute critical appraisal format for Prevalence Studies. Funnel plot and Egger’s regression test were used to ascertain the publication and small study effect on the prevalence. To evaluate the summary prevalence of ID, we used the random effects model with arcsine square-root transformation. Heterogeneity of I^(2)≥ 50% was considered substantial and we determined the heterogeneity with meta-regression. The analyses were performed using STATA(version 16).RESULTS Nineteen studies were included in the meta-analysis. There was publication bias;the trim-and-fill method was used to further ascertain bias. Concerns with control of confounders and the reliable measure of outcome were noted in the critical appraisal. The summary prevalence of ID was 2% [(95%CI: 2%, 3%);I^(2)= 98%] and the adjusted summary prevalence was 1.4%. Meta-regression demonstrated that age of the participants was statistically significantly related to the prevalence;other factors did not influence the prevalence or heterogeneity.CONCLUSION The summary prevalence of ID in India was established to be 2% taking into consideration the individual prevalence studies over the last six decades. This knowledge should improve the existing disability and mental health policies, national programs and service delivery to reduce the national and global burden associated with ID.

摘要： Micronutrients deficiency is a major limiting factor for increasing yield and productivity of major crops in India. Recent findings of multiple micronutrients interactions have evidenced the indispensable role played by micronutrients in plant nutrition. Though they are needed in smaller quantities, however, their availability in the Right amount, at the Right time, and for the Right crop has been a major limiting factor for improving the productivity and yield of Sugarcane in northern Karnataka state of India. This study was conducted to assess the level of Boron (B), Copper (Cu), Iron (Fe), Manganese (Mn) and Zinc (Zn) deficiencies in Sugarcane growing Vertisols of six micro-watersheds in northern Karnataka. The six selected micro-watersheds were intensively traversed and six representative pedons of standard dimensions were dug and horizon-wise soil samples collected and analyzed for various micronutrients using standard analytical procedures. Based on the optimum critical levels of micronutrients, B, Fe and Zn were deficient, ranging from 0.15 - 0.64, 1.23 - 5.92 and 0.11 - 0.64 mg⋅kg?1 respectively while Cu and Mn were in excess, ranging from 1.54 - 7.62 and 1.22 - 7.03 mg⋅kg?1 respectively. The distribution of B, Fe and Zn were inversely proportional to soil depth whereas that of Cu and Mn were irregular, which is an indication of the influence of pedoturbation in these soils. With the current rate of agricultural intensification, unbalanced fertilizer application, depletion of nutrients and no replenishment by smallholders, the results reveal that the current deficiency levels may increase further if appropriate and timely actions are not taken. We therefore recommend the use of site-specific nutrient management, balanced fertilizer application and good agronomic practices. These can enhance nutrient use efficiency in the study area.

摘要： The unprecedented healthcare demand due to sudden outbreak of coronavirus disease 2019 (COVID-19) pandemic has almost collapsed the health care systems especially in the developing world. Given the disastrous outbreak of COVID-19 second wave in India, the health system of country was virtually at the brink of collapse. Therefore, to identify the factors that resulted into breakdown and the challenges, Indian healthcare system faced during the second wave of COVID-19 pandemic, this paper analysed the health system challenges in India and the way forward in accordance with the six building blocks of world health organization (WHO). Applying integrated review approach, we found that the factors such as poor infrastructure, inadequate financing, lack of transparency and poor healthcare management resulted into the overstretching of healthcare system in India. Although health system in India faced these challenges from the very beginning, but early lessons from first wave should have been capitalized to avert the much deeper crisis in the second wave of the pandemic. To sum-up given the likely future challenges of pandemic, while healthcare should be prioritized with adequate financing, strong capacity-building measures and integration of public and private sectors in India. Likewise fiscal stimulus, risk assessment, data availability and building of human resources chain are other key factors to be strengthened for mitigating the future healthcare crisis in country.

摘要： The global decline in farmland bird populations in India is often ignored. The overuse of agrochemicals in farming is the root cause of all these catastrophic results. There is ample evidence in the literature that transitioning to agroecological practices may reverse this trend. We anticipated that the bird population visiting natural farming-Andhra Pradesh Community managed Natural Farming (APCNF), a novel farming approach popular in India, will increase. The study used nested design to compare the number of bird visitations in natural farming versus chemical farming to determine whether natural farming can enhance the bird numbers and diversity. Furthermore, we analyzed the bird species visits to natural and chemical farms in different agroecological zones in Andhra Pradesh, the southernmost state of India. We used the point count survey approach to count the birds on comparable farms. MANOVA and non-parametric analysis are used to examine the findings. The bird species were ranked using a Likert scale. The results show that the average bird population visiting natural vs. chemical farms varies significantly at the 0.05 level of significance, and the bird species visiting both natural farming fields and chemical farms varies between geographies and time interval.

摘要： Dear China!We are all looking forward to a great and successful Olympic Winter Games 2022,Beijing.The simple fact that China is hosting the Winter Olympics in these difficult times of COVID 19 is a big success in itself.Moreover,Beijing will write history as the first ever city to organize both editions of the Olympic Games,Summer and Winter.Beijing,from the bottom of my heart,I send you my best wishes and good luck.

摘要： The emergence of"Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2)"caused by the novel coronavirus(COVID-19)had its origin in Wuhan,China,in November-December 2019.By May 27,2021,the pandemic has affected over 220 countries,with 169,094,393 coronavirus cases and 23,512,509 deaths[1].India reported its first case of COVID-19 infection on January 30,2020[2].The rise of COVID-19 cases brought a barrage of many unforeseen problems for cancer patients and health care workers.Thus,a robust and systematic policy must be followed for the cancer facility's smooth functioning.Currently,India has 273,67,935 cases with 3,15,263 deaths as on March 27,2021[3].The second wave in India started from March 2021 and continued till August 2021 with a peak patient peak load of approximately 4 lacks of new cases in early May 2021.The Third wave started in late November 2021 and is still continuing and in weaning phase.Delta and Omicron variant were the majority strains during 2nd and 3rd wave respectively.

摘要： BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has brought fundamental changes to our problems and priorities,especially those related to the healthcare sector.India was one of the countries severely affected by the harsh consequences of the COVID-19 pandemic.AIM To understand the challenges faced by the healthcare system during a pandemic.METHODS The literature search for this review was conducted using PubMed,EMBASE,Scopus,Web of Science,and Google Scholar.We also used Reference Citation Analysis(RCA)to search and improve the results.We focused on the published scientific articles concerned with two major vital areas:(1)The Indian healthcare system;and(2)COVID-19 pandemic effects on the Indian healthcare system.RESULTS The Indian healthcare system was suffering even before the pandemic.The pandemic has further stretched the healthcare services in India.The main obstacle in the healthcare system was to combat the rising number of communicable as well as noncommunicable diseases.Besides the pandemic measures,there was a diversion of focus of the already established healthcare services away from the chronic conditions and vaccinations.The disruption of the vaccination services may have more severe short and long-term consequences than the pandemic’s adverse effects.CONCLUSION Severely restricted resources limited the interaction of the Indian healthcare system with the COVID-19 pandemic.Re-establishment of primary healthcare services,maternal and child health services,noncommunicable diseases programs,National Tuberculosis Elimination Program,etc.are important to prevent serious long-term consequences of this pandemic.

摘要： BACKGROUND Smoking and chewing tobacco are associated with numerous oral mucosal lesions and conditions,often leading to cancer progression.AIM To investigate the prevalence of precancerous lesions and conditions among the Indian population.METHODS Systematic search was conducted for population or community-based observational epidemiological studies in PubMed,EMBASE,Web of Science,IndMED,Google Scholar,reports of the WHO South-East Asia Region,MOHFW India reports,Science Citation Index,WHO Index Medicus of the South-East Asian Region,Reference Citation Analysis(https://www.referencecitationanalysis.com/)and Open Grey from the earliest available up to 31st January 2022.The effect size was calculated for the prevalence of precancerous lesions and conditions.RESULTS One hundred sixty-two estimates from 130 studies yielded 52 high,71 moderate,and seven low-quality studies from 823845.Point estimate based on crosssectional studies for leukoplakia was 4.3%(95%CI:4.0-4.6),oral submucous fibrosis was 2.7%(95%CI:2.5-3.0),palatal lesions in reverse smokers and nicotine palatine were 5.8%(95%CI:4.4-7.2),and Erythroplakia was 1.2%(95%CI:0.7-1.7),and lichen planus was 1.1%(95%CI:0.9-1.2).Amongst hospital-based studies,the pooled prevalence for Leukoplakia was 6.7%(95%CI:6.0-7.3),oral submucous fibrosis was 4.5%(95%CI:4.2-4.9),lichen planus was 7.5%(95%CI:5.3-9.6),and erythroplakia was 2.5%(95%CI:0.4-4.5),and palatal lesions in reverse smokers and nicotine palatini were 11.5%(95%CI:8.0-15.0).CONCLUSION Precancerous lesions and conditions are prevailing problems among the Indian population.It is mainly due to tobacco use,the smokeless form of tobacco.The meta-analysis indicates that hospital-based studies have a higher effect size of 6.7%than community-based studies.Patients who have already developed this condition may be advised to reduce their exposure to the risk factor to prevent the condition from progressing further.

摘要： Treatment guidelines in many countries for Helicobacter pylori(H.pylori) may differ.Owing to the various characteristics of bacteria,clinical manifestations,resistance to antibiotics and recurrence rate,treatment regimens may change.In this letter,we would like to give an Indian perspective on H.pylori treatment guidelines.